FEATURE: HEATHER ADAMS, MSPAS, PA-C; ELIZABETH NGUYEN, PA-C
Community-Acquired Clostridioides difficile Cases in Children on the Rise Increase in pediatric cases of C difficile is linked to use of broad-spectrum antibiotics, recurrent infections, and a growth in highly virulent strains.
© JENNIFER OOSTHUIZEN / CDC
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Clostridioides difficile is a normal constituent of the gut microbiota.
lostridioides difficile is a spore-forming, anaerobic, gram-positive, toxin-producing bacillus found in the gastrointestinal (GI) tract of humans and animals.1-3 Although C difficile is a normal constituent of the gut microbiota, the overcolonization of this pathogen can cause a range of colonic conditions.1 A case-controlled retrospective study conducted from January 2012 through December 2016 found the overall incidence of communityacquired Clostridioides difficile infection (CDI) cases to be 13.7 per 100,000 children per year, with a substantial increase in cases from 2012 (9.6/100,000).4 In 2018, the Centers for Disease Control and Prevention Emerging Infections Program reported 15,591 cases of C difficile in 10 states. Among children aged 1 to 17 years, the incidence of illness was 26.7 per 100,000 persons and 9.03 per 100,000 persons for community-acquired and health care-associated CDIs, respectively.5 Many factors have increased the rate of CDI in children, such as the increasing use of broadspectrum antibiotics, greater number of recurrent infections, and an increase in highly virulent strains.6,7 It is essential that health care professionals recognize the growing incidence of pediatric CDI in both the community and in health care facilities. Proper hand hygiene and minimizing overprescribing of antibiotics are essential to prevent this deadly infection in children.8 The establishment of an antibiotic stewardship
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